Biophysics of Heart Sounds and Its Application to Clinical Auscultation

Much research has been carried out recently into the means by which heart sounds and murmurs reach the stethoscope from their point of origin. Heart sounds originate as vibrations of the cardiac valves and travel as transverse vibrations with low velocity over the walls of the ventricles and great vessels. Where these structures are in contact with the thoracic surface they emerge, at the `auscultatory areas', and spread like ripples over the chest surface. Murmurs originate in the cavities receiving the blood stream, and are loudest in the cavity that is less distensible. Frequency, damping in transit and the possible misinterpretation of apparent `splitting' seen in phonocardiographic records are discussed. This basic knowledge of modes of transmission allows the interpretation of unusual locations of auscultatory areas in disease states, and explains some puzzling findings obtained with microphones mounted on cardiac catheters.     

An Automated Computerized Auscultation and Diagnostic System for Pulmonary Diseases

Respiratory sounds are of significance as they provide valuable information on the health of the respiratory system. Sounds emanating from the respiratory system are uneven, and vary significantly from one individual to another and for the same individual over time. In and of themselves they are not a direct proof of an ailment, but rather an inference that one exists. Auscultation diagnosis is an art/skill that is acquired and honed by practice; hence it is common to seek confirmation using invasive and potentially harmful imaging diagnosis techniques like X-rays. This research focuses on developing an automated auscultation diagnostic system that overcomes the limitations inherent in traditional auscultation techniques. The system uses a front end sound signal filtering module that uses adaptive Neural Networks (NN) noise cancellation to eliminate spurious sound signals like those from the heart, intestine, and ambient noise. To date, the core diagnosis module is capable of identifying lung sounds from non-lung sounds, normal lung sounds from abnormal ones, and identifying wheezes from crackles as indicators of different ailments.     

正常儿童胸片肺动脉测量研究

本文收集360例正常儿童胸片,测量下列指标:右下肺动脉干横径,右下肺动脉二级支和三级支横径,主肺动脉干横径、肺动脉段凸出度,主肺动脉段面积、左肺动脉弓和胸横径。建立有关指标的正常值范围,分析了胸片指标的相关性,并讨论了胸片肺动脉的正常表现及其X线测量的临床应用     

五音闻诊体系探析

闻珍在望闻问切四诊中占有重要位置,以＂闻而知之谓之圣＂位居第二。五音闻诊在四诊中具有重要意义,古籍中对五音对应五藏和五方四时,正常五音和病变五音等都有详细论述,五音闻诊是一个较完整的诊断方法体系。     

非线性系统相平面法的计算机研究

介绍用计算机绘制各种类型的非线性部分和线性部分构成的非线性系统的相轨迹。实际上,它是一个相平面法的软件包,适用于非线性控制系统理论的分析研究及应用。     

A Four Part Outcome Measurement System

It is suggested that health care outcome measurement systems can be usefully conceptualized in terms of four components. This approach is discussed and illustrated with references to PsychSentinel, a system for measuring psychiatric outcomes. The four components are generic in the sense that they could be used to guide the development of a system for measuring outcomes for any medical specialty. The development of the components are sequential and interdependent. For each component developmental issues and guiding principles are presented. The four components are; a patient classification system, a measure of clinical change (the outcome), a risk-adjustment methodology, and one or more sets of reference norms.     

肺容量-阻抗图测定肺功能的研究

本文介绍了肺容最-阻抗图(△v-△z图)的检查方法,从11例健康人与12例慢性阻塞性肺疾患病人测定的结果表明,肺△v-△z图与人的胸围及肺通气功能状况有关,受呼吸频率和型式的影响不明显。胸围大于80cm的慢性阻塞性肺疾患病人和健康人比较,病人的肺△v-△z的斜率(S)小于健康人,而呼与吸间量大水平距离(D_(E-I)则大于健康人。提示肺△V-△z图在一定条件下可用作辅助诊断肺通气功能的简便方法。     

单纯胸外心脏按压——心肺复苏共识的再认识

胸外心脏按压是抢救心搏骤停的有效措施,连续胸外按压能显著提高复苏成功率。对于院外心搏骤停的急救,大多数目击者不愿意或者不能实施传统的心肺复苏,除此之外,实施单纯胸外心脏按压与传统的心肺复苏有相似的生存率及神经学预后。因此,2010美国心脏协会心肺复苏及心血管急救指南强调普通急救者只需实施单纯胸外心脏按压即可,提高目击者实施心肺复苏的依从性和可行性。单纯胸外心脏按压法应当被大众熟悉,并期待更多的目击者参与到心搏骤停的心肺复苏中来。     

扩髓及髓腔内固定导致肺骨髓脂肪栓塞的大鼠模型

目的：建立以单纯扩髓及髓腔内固定导致肺骨髓脂肪栓塞的大鼠模型。方法：将20只大鼠随机分为实验组和对照组，各组10只。实验组除行双侧完整股骨转子窝处闭合扩髓及髓腔内固定外，均同对照组。两组术后均观察110min，处死大鼠并检查肺脏组织病理改变。按栓塞的肺小动脉及毛细血管数分为Ⅰ－Ⅳ级，结果：实验组行单纯扩髓及髓腔内固定后，全部大鼠的肺小动脉及毛细血管可见扩张，管腔内充满骨髓干细胞及脂肪球，呈现骨髓脂肪栓塞改变；栓塞的等级为Ⅰ级1只，Ⅱ级3只，Ⅲ级4只，Ⅳ级2只。对照组未见肺骨髓脂肪栓塞。结论：单纯扩髓及髓腔骨固定大鼠骨髓脂肪栓塞模型简便易行，经济实用，适于临床研究。     

浅析当代大学生消费透支行为与自卑感的关系

本文通过网络发布自编大学生消费问卷和大学生自卑心理诊断量表进行研究,以考察大学生透支消费与自卑感之间的内在联系为目的,讨论自卑因素对透支消费的影响程度,试探析解决方法。结果发现,自卑感与大学生的透支行为存在相关性,究其根源,与家庭教育密切相关,而人际关系、校园环境等也均为影响因素。     

浅谈《黄帝内经》的人体观

通过对《内经》中"天人合一"、"形神一体"的整体人体观的分析,探讨了《内经》所体现的医学人文精神。医学人文精神推崇的是由人的多重属性和多重关系而展现出来的"人的世界",而《内经》中的身体,是和自然环境、社会环境融为一体的存在,体现了以生态的自然人为本,重视病患精神状态的人文精神。     

慢性肺源性心脏病合并肺血栓栓塞症临床分析

目的探讨由慢性阻塞性肺疾病(COPD)导致的慢性肺源性心脏病(CPHD)合并肺血栓栓塞症(PTE)患者的临床特点。方法选择住院治疗的CPHD合并PTE患者28例(CPHD PTE组),并选择同期住院治疗的CPHD患者30例(CPHD组),比较两组患者的临床症状及体征、血浆D-二聚体(D-dimer)水平、氧分压(PaO2)及肺动脉收缩压(SPAP)。结果CPHD PTE组患者的咳嗽、咳痰、呼吸困难、肺部干湿啰性音等临床症状和体征发生率与单纯CPHD患者比较,差别无统计学意义(P>0.05);但两组患者顽固性右心衰及双下肢不对称水肿发生率间差别有统计学意义(P<0.05)。单纯CPHD组患者经常规治疗后SPAP、血浆D-dimer水平、PaO2与治疗前比较,差异有统计学意义(P<0.05)。CPHD PTE组患者经常规治疗后SPAP、血浆D-dimer水平、PaO2与治疗前比较,差异亦均有统计学意义(P<0.05),两组患者常规治疗后SPAP、血浆D-dimer水平、PaO2比较差异亦均有统计学意义(P<0.05)。结论对于CPHD患者无法用原发病解释的顽固性右心衰、低氧血症、血浆D-dimer及SPAP的升高,尤其是出现双下肢不对称水肿等临床表现,应高度警惕合并PTE的可能性。     

局部肾素-血管紧张素-醛固酮系统与肺纤维化

肺局部组织肾素-血管紧张素-醛固酮系统(RAAS)过度活化参与了肺纤维化的形成过程。对局部RAAS不同部位作用的多样性深入研究,将有利于阐明其在肺纤维化发病中的作用,为临床使用抗纤维化药物提供新思路。     

老年肺心病并发多脏器衰竭临床分析及护理对策

对141例老年慢性肺心病患者中的72例并发多脏器衰竭者进行回顾性分析，发现受累器官除心肺外脑、肾发生率最高，且受损器官越多，年龄越大，病死率越高，合并MSOF的危险因素依次为感染、电解质紊乱、酸碱失衡、高血压、冠心病等，并根据上述特点提出以预防为主，做好各脏器功能的早期监测与保护，尽可能有效地防止各脏器功能衰竭发展到不可逆程度，以降低本病的发生率和死亡率的护理措施。     

呼吸音信号采集分析系统研制及临床应用

目的：研制呼吸音信号采集分析系统,以探讨正常人和呼吸系疾病患者呼吸音的频谱特征,及其与呼吸生理和病理生理之间的关系。方法：运用声电传感器技术和计算机软硬件技术建立起呼吸音信号计算机采集分析系统,对呼吸音信号进行采集、储存、显示和分析处理。结果：发作期哮喘的呼吸音频率增高,强度增大;哮喘缓解期与正常对照组无显著差别。这些与哮喘的病理生理特点。结论：呼吸音信号采集分析系统,能精确采集呼吸音信号;能储存、显示呼吸音波形;对正常人和哮喘患者呼吸音的频谱特征的分析,反映了呼吸生理和病理生理变化的特征;呼吸音信号采集分析系统的研制有助于临床疾病的诊断和疗效观察。     

基于ZigBee的多生理参数测量与分析系统的设计

本文介绍一种基于ZigBee协议的无线传感网络系统,系统采用MCU+RF的方案设计,以ATmegal 128L作为传感器节点的MCU,CC2420作为RF射频模块.采集节点具有6个通道可获取病人的生理参数和环境数据,然后将这些数据传输到接收节点,再通过RS232接口连接到PC.终端设计的Labview程序可以对采集的多种生理参数进行显示、存储和分析.     

A Simple WWW Interface and Quick Response System—Information Query System for Cross-Sectional Body Dimensions

We developed a query and analysis system for normal growth measurement of Japanese children on our WWW server using CGI. It has two subsystems. The first shows standard height and standard weight calculated by height. This subsystem can calculate the difference between measured height and the standard along with deviation and the ratio of measured weight to the standard weight. The second shows standard height, weight, head circumference, and chest circumference. This subsystem can calculate differences between the measurements and the standard as well as deviation. Because of the low amount of output required, very short turn-around time was required. This system also allows use of the same interface no matter which brand terminal is used and has wide reusability. This system will save doctors and nurses the difficulty of looking up a child's data, then having to make the calculation. We also compare the merits of CGI and Java.